Family Planning Services, Post Partum Depression
Conditions
Brief summary
The goal of this clinical trial is to learn whether an integrated package of mental health screening, brief psychosocial support, and family planning counseling delivered within routine postnatal care can improve reproductive and mental health outcomes in postpartum migrant, refugee, and underserved Jordanian women aged 15-49 attending primary health centers in Mafraq Governorate and the Al-Ghour region of Jordan. The main questions it aims to answer are: 1. Does the MARIA intervention increase the use of modern contraceptive methods among postnatal women compared to standard care? 2. Does the MARIA intervention reduce the prevalence and severity of postpartum depression symptoms compared to standard care? Researchers will compare women attending health centers that deliver the full MARIA package (integrated mental health screening, brief psychosocial support, and family planning counseling) to women attending health centers that provide standard care (routine immunization and child health services without the MARIA components) to see if the intervention improves contraceptive use and reduces postpartum depression. Participants will: * Complete a 10-question mental health screening tool (Edinburgh Postnatal Depression Scale) at their routine immunization visit * Receive a brief educational session, psychosocial support, or a referral to specialist mental health services - depending on their screening result * Receive family planning counseling and information about contraceptive options during the same visit * Be followed up by a community health worker, as needed * Participate in three interviews - one in person at enrollment and two by telephone at 4 and 7 months after joining
Interventions
BEHAVIORALMARIA Integrated Maternal Mental Health and Family Planning Package
A multi-component integrated package delivered within routine postnatal and immunization visits at primary healthcare centers. Has 7 components 1. Integrated service delivery: All eligible postnatal women are screened for postpartum depression using Edinburgh Postnatal Depression Scale. Based on score, primary healthcare providers deliver stepped-care psychosocial support. Family planning counseling is integrated into the same visit for all women. 2. Community health workers community outreach 3. Provider training 4. Supportive Supervision 5. Communication/educational material (brochures, pamphlets, videos in waiting area) 6. A project website and automated electronic Edinburgh Postnatal Depression Scale tool accessible via QR code for use by providers, community health workers, and women 7. online learning courses on implementation research and leadership and management
Sponsors
Eastern Mediterranean Public Health Network
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
15 Years to 49 Years
Healthy volunteers
No
Inclusion criteria
* Postpartum women aged 15-49 years * Attending selected primary healthcare centers for infant immunization or healthy child visits * Unmet family planning need: interested in using contraception but currently not doing so * Living in study villages (Mafraq or Al-Ghour) * Migrant, refugee, or underserved Jordanian women
Exclusion criteria
* Currently using a modern contraceptive method * Unmarried women * Unable to provide informed consent * Planning to leave the study area within 7 months
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Number of Participants adopting any modern contraceptive method since baseline | from baseline until 7 months |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| number of women with postpartum depression | from baseline until 7 months | Edinburgh Postnatal Depression Scale |
| number of women who continue the modern contraception | at the end of the 7 months follow up | — |
| change in baseline in the number of women who feel empowered | at 7 months | Oxfam Women's Empowerment Measurement Tool |
| change in baseline in the number of women with positive attitude towards pregnancy | at 7 months | Attitude Toward Potential Pregnancy Scale (APPS) |
| number of women with improved knowledge of family planning since baseline | at 7 months | — |
| improved couple communication since baseline | at 7 months | — |
| improved provider capacity in family planning and mental health services | at 7 months | — |
Countries
Jordan
Contacts
CONTACTRanda K. Saad, MD
CONTACTSara Abu Khudair
Outcome results
None listed